Individual
DALE PHILLIP GREYSLAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
3491 TITANIC CIR, INDIALANTIC, FL 32903-1871
(407) 451-0192
Mailing address
PO BOX 410185, MELBOURNE, FL 32941-0185
(407) 451-0192
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104508
FL
Other
Enumeration date
05/08/2008
Last updated
02/14/2023
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